Abstract
Abstract:Background: Nonsuicidal self-injury (NSSI) has increased rapidly and is frequently linked to suicidal behavior; it has been argued that these behaviors are key points on a self-harm continuum. Aims: The current research explored self-harm and help-seeking behaviors, with the aim of identifying possibilities for prevention of further harm, including suicide. Methods: An online survey of 304 New Zealanders was undertaken, with the majority being aged under 25 and female. Results: Nearly half of the sample had engaged in self-harm and most of those had experienced suicidal thoughts; close to a quarter had made a suicide attempt. NSSI was used as a way of dealing with emotional distress. Very few sought help of any kind, especially professional support; of those who did seek professional support, most found it helpful but did not necessarily stop self-harming as a result. Limitations: Men are under-represented in the sample – though this is in accordance with the population of people who engage in NSSI. Conclusion: Many participants engaged in NSSI and also had suicidal thoughts using NSSI as an emotion regulation strategy; some participants appeared to use NSSI rather than attempting suicide. Given a link between NSSI and suicidal thoughts and behaviors, reluctance to seek help and on-going injurious behavior among some who do seek help, there is a need for increased identification and proactive support specifically focusing on improving emotion regulation and targeted at injurious behavior.
References
2020). What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry, 20(1), 293–315. 10.1186/s12888-020-02659-0
(2012). The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents: Distinguishing risk factors and psychosocial correlates. Child and adolescent psychiatry and mental health, 6(1), Article
(11 . 10.1186/1753-2000-6-112013). Predictors of continuation and cessation of nonsuicidal self-injury. Journal of Adolescent Health, 53(1), 40–46. 10.1016/j.jadohealth.2013.01.009
(2017). Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria. Journal of Affective Disorders, 215, 1–8. 10.1016/j.jad.2017.03.025
(2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64. 10.1016/j.cpr.2015.02.009
(2012). Self-injury as embodied emotion work: Managing rationality, emotions and bodies. Sociology, 46(3), 442–457. 10.1177/0038038511422589
(2014). Narrating the self-injured body. Medical Humanities, 40(2), 111–116. 10.1136/medhum-2013-010488
(2011). The construction of self-injury in the clinical literature: A sociological exploration. Suicide and Life-Threatening Behavior, 41(1), 98–109. 10.1111/j.1943-278X.2010.00003.x
(2017). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, Article
(1946 . 10.3389/fpsyg.2017.019462017). Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort. Journal of Affective Disorders, 221(Supplement C), 89–96. 10.1016/j.jad.2017.06.029
(2010). Youth perceptions of suicide and help-seeking: “They’d think I was weak or ‘mental’”. Journal of Youth Studies, 13(6), 699–715. 10.1080/13676261003801747
(2016). Young women’s experiences of self-harm: Commonalities, distinctions and complexities. Young, 24(1), 17–35. 10.1177/1103308815613680
(2017). Non-suicidal self-injury: Suicide risk or social activity? New Zealand Journal of Psychology, 46(3), 106–114
(2018). Female deliberate self-harm: The women’s perspectives. Women's Studies, 47(8), 845–867. 10.1080/00497878.2018.1524762
(2021). Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents. Journal of Affective Disorders, 292, 337–344. 10.1016/j.jad.2021.05.104
(2015). Self-harm in young people: Prevalence, associated factors, and help-seeking in school-going adolescents. International Journal of Mental Health Nursing, 24(6), 485–494. 10.1111/inm.12144
(2017). Non-suicidal self-injury in a New Zealand student population: Demographic and self-harm characteristics. New Zealand Journal of Psychology, 46(3), 156–163.
(2015). Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: Cross-sectional and longitudinal survey data. Child and Adolescent Psychiatry and Mental Health, 9(1), 28–39. 10.1186/s13034-015-0055-6
(2016). Relations between nonsuicidal self-injury and suicidal behavior in adolescence: A systematic review. PLoS ONE, 11(4), Article
(e0153760 . 10.1371/journal.pone.01537602020). Does nonsuicidal self-injury predict later suicidal attempts? A review of studies. Archives of Suicide Research, 26(2), 1–19. 10.1080/13811118.2020.1822244
(2018). Factors influencing professional help-seeking for suicidality: A systematic review. Crisis, 39(3), 175–196. 10.1027/0227-5910/a000485
(2009). Mental disorders in self-cutting adolescents. Journal of Adolescent Health, 44(5), 464–467. 10.1016/j.jadohealth.2008.10.003
(2012). Nonsuicidal self-injury, suicidal behavior, and their co-occurrence as viewed through the lens of the interpersonal theory of suicide. Current Directions in Psychological Science, 21(5), 342–347. 10.1177/0963721412454873
(2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(5), 226–239. 10.1016/j.cpr.2006.08.002
(2019). Predicting status along the continuum of suicidal thoughts and behavior among those with a history of nonsuicidal self-injury. Psychiatry Research, 273, 514–522. 10.1016/j.psychres.2019.01.067
(2020). Anti-suicide function of nonsuicidal self-injury in female inpatient adolescents. Frontiers in Psychiatry, 11, Article
(490 . 10.3389/fpsyt.2020.004902015). When self-reliance is not safe: Associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents. International Journal of Environmental Research and Public Health, 12(4), 3741–3755. 10.3390/ijerph120403741
(2023). Statistics on suicide in New Zealand: What does the data tell us? https://mentalhealth.org.nz/suicide-prevention/statistics-on-suicide-in-new-zealand
. (2019). Suicide facts: 2016 data (provisional). https://www.health.govt.nz/publication/suicide-facts-2016-data-provisional
. (2022). Adolescents with non-suicidal self-harm – who among them has attempted suicide? Archives of Suicide Research, 27(3), 866–879. 10.1080/13811118.2022.2072254
(2021). Implementing exploratory mediation to clarify the nonsuicidal self-injury – suicidality connection. Journal of Psychopathology and Behavioral Assessment, 43(1), 206–215. 10.1007/s10862-020-09850-3
(2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine, 46(2), 225–236. 10.1017/S0033291715001804
(2019). Reciprocal risk: The longitudinal relationship between emotion regulation and non-suicidal self-injury in adolescents. Journal of Abnormal Child Psychology, 47(2), 325–332. 10.1007/s10802-018-0450-6
(2021). Nonsuicidal self-injury thoughts and behavioural characteristics: Associations with suicidal thoughts and behaviours among community adolescents. Journal of Affective Disorders, 282, 1247–1254. 10.1016/j.jad.2020.12.201
(2019). Discovering one’s own way: Adolescent girls’ different pathways into and out of self-harm. Journal of Adolescent Research, 35(5), 605–634. 10.1177/0743558419883360
(2014). Correlates of suicide attempts among self-injurers: A meta-analysis. Clinical Psychology Review, 34(4), 282–297. 10.1016/j.cpr.2014.03.005
(2018). Nonsuicidal self-injury: Increased prevalence in engagement. Suicide and Life-Threatening Behavior, 48(6), 690–698. 10.1111/sltb.12389
(2014). Assessment of nonsuicidal self-injury: Development and initial validation of the non-suicidal self-injury-assessment tool (NSSI-AT). Psychological Assessment, 26(3), 935–946. 10.1037/a0036611
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